Objective:To conduct a scoping review of research on the self-advocacy of adult cancer patients to identify their self-advocacy needs, behaviors, strengths and weaknesses, so as to provide guidance for future research in this field.Methods:Using the scoping review guidelines of Joanna Briggs Institute in Australia as a methodological framework, relevant literatures were searched in PubMed, Web of Science, Cochrane Library, Embase, Science Direct, CINAHL, Scopus, China National Knowledge Infrastructure, Wanfang, VIP and China Biology Medicine disc. The search period was from establishment of the databases to December 2023, and the results were summarized and analyzed.Results:A total of 14 articles were included, and self-advocacy needs included six types of needs, such as symptom management, communication, interpersonal support, disease information, decision-making and emotional management. Self-advocacy included four aspects, including seeking information, self-decision-making, strengthening contact with the outside world and effective communication.Conclusions:Adult cancer patients have diverse types of self-advocacy needs and certain self-advocacy behaviors. Future research should pay attention to self-advocacy needs assessment, develop corresponding tools, focus on self-advocacy behaviors, leverage the advantages of self-advocacy and explore strategies to achieve effective self-advocacy support.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been reapproved for heart failure (HF) therapy in patients with and without diabetes. However, the initial glucose-lowering indication of SGLT2i has impeded their uses in cardiovascular clinical practice. A challenge of SGLT2i then becomes how to separate their anti-HF activity from glucose-lowering side-effect. To address this issue, we conducted structural repurposing of EMPA, a representative SGLT2 inhibitor, to strengthen anti-HF activity and reduce the SGLT2-inhibitory activity according to structural basis of inhibition of SGLT2. Compared to EMPA, the optimal derivative JX01, which was produced by methylation of C2-OH of the glucose ring, exhibited weaker SGLT2-inhibitory activity (IC₅₀ > 100 nmol/L), and lower glycosuria and glucose-lowering side-effect, better NHE1-inhibitory activity and cardioprotective effect in HF mice. Furthermore, JX01 showed good safety profiles in respect of single-dose/repeat-dose toxicity and hERG activity, and good pharmacokinetic properties in both mouse and rat species. Collectively, the present study provided a paradigm of drug repurposing to discover novel anti-HF drugs, and indirectly demonstrated that SGLT2-independent molecular mechanisms play an important role in cardioprotective effects of SGLT2 inhibitors.

Objective To analyze the distribution, survival conditions, and medical support of newly diagnosed occupational pneumoconiosis (hereinafter referred to as pneumoconiosis) patients in Zhangdian District, Zibo City. Methods A total of 1 189 newly diagnosed pneumoconiosis patients in Zhangdian District from 1956 to 2019 were selected as the study subjects using retrospective method. Data of their age of onset, years of occupational exposure, category of working industry, type of pneumoconiosis, and status of medical support was collected and analyzed. Results The median and the 25th-75th percentiles ［M (P₂₅, P₇₅)］ of the age of onset were 51.8 (45.5, 56.1) years, and the mortality was 37.0%. The majority of pneumoconiosis cases were silicosis (45.2%) and coal workers' pneumoconiosis (39.8%). The highest prevalence of pneumoconiosis was in the coal mining and washing industry (42.4%), followed by manufacturing (33.4%). Pneumoconiosis patients in stage Ⅰ,Ⅱ, and Ⅲ accounted for 89.1%, 8.7%, and 2.2%, respectively. The M (P₂₅, P₇₅) of the length of work exposed to dust were 24.1 (16.5, 29.9) years.The higher stage of pneumoconiosis the shorter of the length of work exposed to dust among these pneumoconiosis patients(all P<0.05). The overall survival rate, the 5-year survival rate and the 10-year survival rate of these pneumoconiosis patients were 63.0%, 92.3% and 85.9%, respectively. Among the 749 surviving cases, 60.8% were aged 60.0 to <80.0 years. In terms of social security, 100.0% surviving cases enjoyed basic medical insurance, meanwhile, 96.1% and 81.8% patients were covered by major medical insurances and occupational injury insurances, respectively. The M (P₂₅, P₇₅) of age at death were 73.1 (64.0, 77.1) years. The main causes of death were respiratory diseases (59.3%) and malignant tumors (20.4%). Conclusion The prevalent types of pneumoconiosis in Zhangdian District, Zibo City, are coal workers' pneumoconiosis and silicosis. Medical support and assistance are relatively limited. The pneumoconiosis prevention and control focus should be on silicosis and coal workers' pneumoconiosis, particularly in the manufacturing industry.

Objective:To investigate the anatomy of lateral maxillocervical boot-shaped perforator fasciocutaneous flap and its clinical effect on repairing soft tissue defect of zygomatic-temporal region.Methods:(1)From December 2017 to December 2020, five fresh adult cadaver specimens were infused with gelatin lead oxidate and underwent one-time arteriography.The X-ray image was imported into Mimics 17.0 software, divided and colored based on the head and face anatomy, and the distribution and anastomosis of the arteries involved in the lateral maxillocervical boot-shaped perforator fasciocutaneous flap were observed.The head and neck samples of another 5 (10 sides) fresh adult cadavers were infused with red latex artery to establish the surgical model, and then dissected layer by layer to investigate the blood supply and the source of perforating artery of this flap.(2) The patients with zygomatic-temporal lesions were treated in the Department of Plastic Surgery, the First Affiliated Hospital of Anhui Medical University.They were treated with the lateral maxillocervical boot-shaped perforator fasciocutaneous flap to repair the wound left after lesion resection. The survival of the flap and the healing of the incision were observed after surgery and the appearance and sensation of donor and recipient sites as well as tumor recurrence were followed up.Results:(1) The pedicle of the lateral maxillocervical boot-shaped perforator fasciocutaneous flap is mainly nourished by the superficial temporal artery and its perforator.The average diameter of the maximum three perforations is (0.44±0.04) mm, (0.90±0.08) mm, (0.73±0.05) mm.The fascial vascular network and subdermal vascular network formed by perforating arteries from superficial temporal artery and branching arteries from facial artery at different layers are the anatomical basis for ensuring blood supply of lateral maxillocervical boot-shaped perforator fasciocutaneous flap. (2) A total of 12 patients with zygomatic-temporal lesions were treated clinically, including 8 males and 4 females aged 42-79 years, including 2 cases of senile sebaceous keratosis, 3 cases of squamous cell carcinoma, 1 case of skin ulcer and 6 cases of basal cell carcinoma. The range of defect after resection of the lesions was 4 cm×3 cm-9 cm×8 cm. The flap area was 5 cm×3 cm-11 cm×9 cm, the flap pedicle width was 2-3 cm, length was 2-4 cm, After surgery, the blood supply of the flap was good without necrosis, the wound were covered by first treatment. After 6-18 months of follow-up, the donor and recipient areas presented natural appearance, no swelling, no paresthesia and facial paralysis, and no recurrence of cancer.Conclusions:The lateral maxillocervical boot-shaped perforator fasciocutaneous flap pedicled with perforating branch of superficial temporal artery has reliable blood supply. Using this flap to repair large soft tissue defects in zygomatic-temporal region has the advantages of simple operation, similar color and texture, and good appearance.

Objective:To investigate the anatomy of lateral maxillocervical boot-shaped perforator fasciocutaneous flap and its clinical effect on repairing soft tissue defect of zygomatic-temporal region.Methods:(1)From December 2017 to December 2020, five fresh adult cadaver specimens were infused with gelatin lead oxidate and underwent one-time arteriography.The X-ray image was imported into Mimics 17.0 software, divided and colored based on the head and face anatomy, and the distribution and anastomosis of the arteries involved in the lateral maxillocervical boot-shaped perforator fasciocutaneous flap were observed.The head and neck samples of another 5 (10 sides) fresh adult cadavers were infused with red latex artery to establish the surgical model, and then dissected layer by layer to investigate the blood supply and the source of perforating artery of this flap.(2) The patients with zygomatic-temporal lesions were treated in the Department of Plastic Surgery, the First Affiliated Hospital of Anhui Medical University.They were treated with the lateral maxillocervical boot-shaped perforator fasciocutaneous flap to repair the wound left after lesion resection. The survival of the flap and the healing of the incision were observed after surgery and the appearance and sensation of donor and recipient sites as well as tumor recurrence were followed up.Results:(1) The pedicle of the lateral maxillocervical boot-shaped perforator fasciocutaneous flap is mainly nourished by the superficial temporal artery and its perforator.The average diameter of the maximum three perforations is (0.44±0.04) mm, (0.90±0.08) mm, (0.73±0.05) mm.The fascial vascular network and subdermal vascular network formed by perforating arteries from superficial temporal artery and branching arteries from facial artery at different layers are the anatomical basis for ensuring blood supply of lateral maxillocervical boot-shaped perforator fasciocutaneous flap. (2) A total of 12 patients with zygomatic-temporal lesions were treated clinically, including 8 males and 4 females aged 42-79 years, including 2 cases of senile sebaceous keratosis, 3 cases of squamous cell carcinoma, 1 case of skin ulcer and 6 cases of basal cell carcinoma. The range of defect after resection of the lesions was 4 cm×3 cm-9 cm×8 cm. The flap area was 5 cm×3 cm-11 cm×9 cm, the flap pedicle width was 2-3 cm, length was 2-4 cm, After surgery, the blood supply of the flap was good without necrosis, the wound were covered by first treatment. After 6-18 months of follow-up, the donor and recipient areas presented natural appearance, no swelling, no paresthesia and facial paralysis, and no recurrence of cancer.Conclusions:The lateral maxillocervical boot-shaped perforator fasciocutaneous flap pedicled with perforating branch of superficial temporal artery has reliable blood supply. Using this flap to repair large soft tissue defects in zygomatic-temporal region has the advantages of simple operation, similar color and texture, and good appearance.

Clinical data and follow-up of a case of congenital disorder of glycosylation type Ia (CDG-Ia) combined with dilated cardiomyopathy admitted to the Department of Cardiology, Children′s Hospital of Nanjing Medical University were analyzed retrospectively.The 5-year-old female patient was admitted in December 2016 due to recu-rrent shortness of breath for 2 months.Clinical symptoms and signs included repeated attacks of shortness of breath, physical retardation, malnutrition, binocular esotropia, multiple episodes of hypoglycemia, hepatosplenomegaly, hypotonia and other multi-system damages.Cardiac echocardiography suggested the feature of dilated cardiomyopathy, including the significant enlargement of the left ventricle, and decreased systolic function.Genetic testing revealed a compound heterozygous mutation in the PMM2 gene, and as a result, the patient was diagnosed as CDG-Ia.The patient′s condition improved after symptomatic treatments such as Cedilanid, Dopamine, Dobutamine, Furosemide, as well as support treatments like myocardium nutrition, blood sugar maintenance, liver protection, etc.After discharge, the patient was given oral Digoxin, Betaloc, Captopril and diuretics, and hypoglycemia-controlling agents.The patient was followed up every 3-6 months.After more than 2 years of follow-up, the heart function and heart enlargement gradually returned to normal.During the Corona Virus Disease 2019 outbreak, self-withdrawal continued for 2 months.Re-examinations showed decreased cardiac function and enlarged left ventricle again.Medications were resumed again, and the patient was followed up closely.This case report suggested that CDG-Ia may be associated with dilated cardiomyopathy, and the cardiac phenotype may be improved by symptomatic supportive treatment.

Objective:To explore the risk factors of thrombocytopenia in children with patent ductus arteriosus (PDA) after transcatheter closure, and to establish a prediction model of thrombocytopenia after transcatheter closure of PDA.Methods:A total of 39 PDA children with thrombocytopenia after transcatheter closure treated in Children′s Hospital of Nanjing Medical University from November 2016 to January 2020 were selected.During the same period, 138 PDA children without thrombocytopenia after transcatheter closure were included in the control group. Logistic regression model was used to explore the possible risk factors of thrombocytopenia after transcatheter closure in PDA children, and a random forest model was established to predict the occurrence of thrombocytopenia after transcatheter closure of PDA. Results:After transcatheter closure of PDA, children developed thrombocytopenia within 1 to 7 days, and the platelet count recovered within 2 to 22 days. Logistic regression model suggested that the diameter of pulmonary artery end of arterial catheter ( OR=9.54, 95% CI: 2.08-48.84, P=0.004)and preoperative platelet count( OR=0.99, 95% CI: 0.98-0.99, P=0.001)were correlated with the occurrence of thrombocytopenia after transcatheter closure of PDA.The random forest model indicated that PDA inner diameter was the most important factor for predicting the occurrence of thrombocytopenia after transcatheter closure of PDA. Conclusions:A large diameter of arterial duct is an important risk factor and increased preoperative platelet count is a protective factor for thrombocytopenia after transcatheter closure of PDA.Diameter is of the greatest significance in predicting the occurrence of thrombocytopenia after transcatheter closure of PDA.

CD80, CD86 and their receptors CD28 and CTLA-4 provide the necessary costimulatory signals for T cell. Virus infection may inhibit the expression of CD80 or CD86 to impair the function of specific T lymphocytes, thus avoid immune surveillance; it can also lead to the disorder of the expression of CD80 or CD86, inducing dysfunction of immune cells in the body, thus causing continuous infection and inflammation. Therefore, costimulation pathway CD80/CD86: CD28/CTLA-4 has great significance for the body to maintain a normal immune response, as well as the clearance of the virus and the recovery of the body. This article summarizes the studies on CD80, CD86 and their receptors in viral infection in recent years, and provides theoretical ideas and references for the control of viral infection.

Objective To analyze the risk factors of periprosthetic acetabular fracture in total hip arthroplasty (THA) and to discuss the prevention and management.Methods A total of 1 023 patients (1 168 hips) undergoing THA were retrospectively analyzed between January 2012 and June 2015.There were 421 males (507 hips) and 602 females (661 hips),aged from 23 to 96 years with mean age of 64.2± 15.0 years.Primary total hip arthroplasty was conducted in 1 053 hips,while revision surgery was conducted in 115 hips.The reasons of periprosthetic acetabular fracture were summarized.Age,gender,BMI,primary disease,left or right sides,surgical approach,osteoporosis,prosthetic type,the coverage rate of acetabulum-bone,and the amount of surgical operation annually were compared between non-fracture and fracture.Risk factors associated with the fracture were analyzed using chi square test followed by a multivariate logistic regression.Furthermore,revision surgery was compared with primary THA using chi square test.Results The incidence of intraoperative periprosthetic acetabular fractures was 2.8％ (33/1 168).The incidence of fracture was higher in revision surgery than that in primary THA (6.1％ vs.2.5％).Multivariate logistic regression showed that primary disease (developmental dysplasia of the hip and rheumatoid arthritis),osteoporosis,uncemented acetabular cup,the high-er coverage rate of acetabulum-bone,and the less amount of surgical operation annually were prone to appear periprosthetic acetabular fracture in primary THA.Among the 33 patients with acetabular fractures,13 cases (39.4％,13/33) were found intraoperatively and 20 cases (60.6％,20/33) postoperatively.Acetabular wall fractures were in 26 (78.8％,26/33),column fractures in 2 (6.1％,2/33),transverse fractures in 2 (6.1％,2/33) and quadrilateral surface fractures with prosthetic central dislocation in 3 (9.1％,3/33).Seven cases of 26 stable fractures and 6 cases of 7 unstable fractures were found intraoperatively.Acetabular wall fractures were fixed by additional augmentation screws or accepted no special treatment,and column fractures were fixed with plate.One quadrilateral surface fracture was accepted revision surgery using Jumbo cup,2 quadrilateral surface fractures and 2 transverse fractures with reconstruction cage.The patients were followed up for 42.3±13.7 months (range 29-60 months).The Harris hip score was 83.3±6.6 (range 72-94) at last follow-up.No complication,such as hip dislocation,osteolysis,and prosthetic loosening was reported.Conclusion Most of periprosthetic acetabular fiactures are wall fractures which could not endanger the periprosthetic stability.The detection rate of acetabular stable fracture is lower than that of unstable fracture in operation.Primary disease (developmental dysplasia of the hip and rheumatoid arthritis),osteoporosis,uncemented acetabular cup,the higher coverage rate of aeetabulum-bone,the less amount of surgical operation annually are the intraoperative risk factors which closely related to acetabular fractures of primary THA.The risk of intraoperative periprosthetic acetabular fractures in revision THA is higher than that in primary THA.